AB1371 USE OF ULTRASOUND TO DIAGNOSE INTERSTITIAL LUNG DISEASE IN RHEUMATIC DISEASES ON RUSSIAN COHORTS OF PATIENTS.
Authors: O. Ovsyannikova, O. Koneva, L. Garzanova, L. P. Ananyeva, A. Khelkovskaia-Sergeeva, R. Shayakhmetova, O. Desinova, M. Starovoytova
Journal: Annals of the Rheumatic Diseases (2022)

Background Interstitial lung disease (ILD) is one of the most relevant extra-articular manifestations of rheumatic diseases resulting in a substantial increase in morbidity and mortality. High-resolution computed tomography (HRCT), which is the current gold standard for diagnosis and evolutionary control, is problematic owing to ionizing radiation, cost, and accessibility. In the last decade, the use of lung ultrasound (LUS) in clinical medicine has increased. LUS is an accurate tool for the diagnosis of pneumonia, pneumothorax, acute pulmonary edema, and pleural effusion. LUS may also be useful in detection of ILD by the evaluation of B-lines, the sonographic hallmark of the interstitial syndrome. Objectives To compare semi-quantitative scores of B lines in patients with rheumatic disease with different intensity of lung fibrosis. Methods 50 pts with ILD of rheumatic disease such as: vasculitis n=11 (mean age 40.7± 9.1, fem 5); dermatomyositis (DM), anti-synthetase syndrome (ASS), polymyositis (PM) n=20, (mean age 48.7± 11.9, fem 13); rheumatoid arthritis (RA) n=9 (mean age 56.5± 6.3, fem 7); Sjogren’s syndrome (SSj) n=9 (mean age 59.6± 12.3, fem 8). To determine the intensity of fibrosis of ILD we used a limited/extensive classification for disease extent, integrating HRCT observation. According this scheme pts were divided into 2 groups: group 1 included 33 pts had “limited” lung disease (lung lesions less than 20%) and the group 2 included 17 pts had “extensive” lung disease (lung lesions greater than 20%). LUS examination protocol that include the anterior, lateral, and/or posterior thorax have been suggested The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 58 scanning sites. In each patient ULC score was obtained by summing the number of comets detected as previously recommended. The data were collected in protocols for statistical testing. Other data collected including biological results (high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR)). Results the mean score of B-lines in each groups were: vasculitis (n=11) 21,4 ±12,6; (DM, PM, ASS) (n=20) 41,3±20.8; RA (n=9) 56.5±6.3; SSj (n=9) 59 ± 11.8. The mean score of B-lines in groups pts with different intensity of fibrosis are presented in Table 1. Table 1. Groups mean score of B-lines Anterior chest Mean score of B-lines Posterior chest Mean score of B-lines Limited (n=33) 22±14 6.6 ±7.1 5 [1;10] 15.4±13.4 Extensive (n=17) 61.3±27.4 24.2±12.5 36.4±22.4 P &lt;0.001 &lt;0.001 &lt;0.001 The correlations in Table 1 may confirm the connection of B-lines score and extensity of ILD association with rheumatic disease. The mean score of ULCs determined in all 50 pts didn’t correlate with dates of ESR (R = 0,188, p&gt;0.05) and hsCRP (R= -0,07, p&gt;0.05). Conclusion In Russian cohorts presence of LUS score is associates with more severe ILD. Echographic examination of the lung allows evaluating the severity of lung fibrosis and can be used as an additional simple and available method to assess the ILD of rheumatic disease, but we couldn’t find correlation with hsCRP and ESR. Disclosure of Interests None declared